Need input!! about noncurrent conditions

J.B.

J.B.

PEB Forum Regular Member
PEB Forum Veteran
Registered Member
Hello...

I have a history of repeated rectoceles and cystocele (the condition isn't important). My last surgery is holding so I do NOT currently have a rectocele. The catch is... because of recurrence of the condition and the risk of losing bladder function, etc... the specialist warned me not to strain while lifting for the rest of my life, no increase abdominal pressure; all limitations that my military GYN agrees. It is that specific item that makes me unable to perform Soldier duties.
With the limitations set because of the risk of recurrence; how is the VA / DOD is going to look at it? Also, how do I make the connection to the VA? I know it is going to be difficult as the condition in not currently happening.
 
Last edited:
This is very important...

You just did your C&P evaluations yesterday.

When you met with or spoke to your VA MSC, did you claim your rectoceles and cystocele? From what I understand, chronic pelvic pain is a referred condition to the MEB/PEB, correct?

Get a copy of the C&P evaluation as soon as possible, if the provider who did the examination does not include a diagnosis, make sure your MSC gets you an appointment to see a gynecologist or other specialist to get diagnosed.

You will know that they did not diagnose the condition, if there is language on the C&P evaluation to this effect...

For the claimants claimed condition of XXXXXXX, there is no diagnosis because there is no pathology to render a diagnosis.

To that end, if the C&P evaluation does no address the condition of rectoceles and cystocele, jump on your MSC and make sure you get evaluated.

If you get a response from your MSC or PEBLO, that the VA will look at all of your medical records to rate you, take that with a grain of salt. In my opinion they are cruising through the cases, only rating what is on the C&P evaluation and looking at nothing more. This means the C&P needs to be as accurate as possible.

Next thing I want to point out is that if your referred condition is chronic pelvic pain, make absolutely 100% sure that the PEB finds the condition of rectoceles and cystocele as unfitting too. Without the rectoceles and cystocele would there be pain in the pelvic area? Probably not.


Rectocyles and cystocele rate at 50% and would not meet retention standards under AR 40-501 Chapter 3-5(n) and Chapter 3-18, possible a,b,c
 
Gsfowler,

I really appreciate you taking time to respond.Let me answer your questions in order....

When you met with or spoke to your VA MSC, did you claim your rectoceles and cystocele?

Yes I claimed rectoceles and cystoceles. Fortunately, My Gen MED C&P did not cover any of my GYN issues, they went ahead and scheduled my to see a specialist. I see her on Tuesday. So I have three days to make my "Battle Plan"

From what I understand, chronic pelvic pain is a referred condition to the MEB/PEB, correct?

Chronic Pelvic pain was my referred condition. I want to make clear that if it was just pain I could push on through BUT it is the limitations put on me by the Specialist that make me unable to perform Soldier duties. No lifting heavier than 35 lbs for the rest of my life.


Without the rectoceles and cystocele would there be pain in the pelvic area?

No. Matter of fact The first time the surgery was done 2009 (by Army GYN) I had no residual pain. Unfortunately the repair did not hold and had to be redone in 2012 (Army GYN sent to me to a specialist). My pain is well documented since shortly after the 2012 surgery by the Specialist who did the second surgery, the Army GYN and the Pain Specialist (Army GYN sent me to this Specialist).

I realize it is important to try and get the C&P examiner to make the connection. I have my Uro-gynecologist records from my second set of surgeries along with records from the Pain Specialist I saw this past fall, I plan on taking both with me.

SO.... How do I approach the exam? I am unsure of how to phrase my wording... Do I need to worry that the Doctor will refuse to make the connection? From your answers, I assume there is a way to get around the VA rule that the condition must be "Current". Is that assumption correct?
 
I appreciate input from anyone...
 
Bring each and every medical note regarding the rectoceles and cystoceles to the C&P specialist evaluation. This will assist the physician in making a diagnosis. It pleases me to see that your MSC did get you a follow up for C&P evaluation.

I think you are in good hands at this moment, just make sure to get a copy of the evaluations for review.

I do not feel that the condition needs to be recurrent. Residuals from the condition state that you cannot perform the duty per AR 40-501. The VASRD is pretty clear that rectoceles and cystoceles will be rated at 50%. You may also be eligible for special medical compensation for loss of use of a creative organ.
 
Anyone else have any tips?? My appt is first thing in the am.
 
Just completed my GYN C&P. She did the interview and used my specialty doctors notes as reference when she was doing her write up. She said she didnt need to do an exam as all surgery notes and follow up exams were well documented down to the scars. I asked her straight up, "Are you going to list the rectocele and cystocele with all the other issues being residuals of those two?" She said that she would be writing it up like that because you had to have them first before the repeated surgeries and resulting complications. So I hope what she said to me is what she write,because if so, wouldnt this apply?
7623 Pregnancy, surgical complications of:


With rectocele or cystocele....................................................................................... 50

With relaxation of perineum .................................................................................... 10

From this point I just wait on the NARSUM or do I ask for copies of the exams?
 
Get copies for sure. In my opinion, the only rating that can come from the referred condition (Chronic Pelvic Pain) will be 50% PDRL. The MEB may not see things this way and might try to low ball you. Stand your ground and take it all if the way to the PEB if you have to.

It should read so thing like this on the NARSUM, "Chronic Pelvic Pain, diagnosed by the VA as Rectocyles and Cystocyle"
 
Got a quick look at my unsigned NARSUM. How the hell do i meet retention standards for the rectocele when that is the condition that my life-long lifting restriction is based on?

I fall below standards on the chronic pelvic pain is based of perineocele and nueromas (tumors on nerves) and not rectocele or cystocele (these meet retention standards).

I have a total of 6 conditions that fall below retention standards (1 of which is PTSD).
 
Last edited:
J.B. said:
Got a quick look at my unsigned NARSUM. How the hell do i meet retention standards for the rectocele when that is the condition that my life-long lifting restriction is based on?

I fall below standards on the chronic pelvic pain is based of perineocele and nueromas (tumors on nerves) and not rectocele or cystocele (these meet retention standards).

I have a total of 6 conditions that fall below retention standards (1 of which is PTSD).
Click to expand...
Once you get the NARSUM in front of you, request a IMR that the conditions are unfitting. Sometimes I feel like they leave conditions off, just to see what the service members will do.

Try not to get discouraged, the MEB and MEB physicians do not have the final say, that comes from the PEB.
 
OK. Got my Narsum and all the C&P exams. How the heck do I interpret this stuff so I get an idea of what is what? I go to MEB legal on Monday but if there is leg work I can do in the meantime I would like to start. I have 6 conditions that are medically unacceptable, 14 medically acceptable and 1 does not constitute disability.

Also, I dont meet retention standards for PTSD but dont see the "magic" statements that can help determine ratings.
 
gsfowler said:
Bring each and every medical note regarding the rectoceles and cystoceles to the C&P specialist evaluation. This will assist the physician in making a diagnosis. It pleases me to see that your MSC did get you a follow up for C&P evaluation.

I think you are in good hands at this moment, just make sure to get a copy of the evaluations for review.

I do not feel that the condition needs to be recurrent. Residuals from the condition state that you cannot perform the duty per AR 40-501. The VASRD is pretty clear that rectoceles and cystoceles will be rated at 50%. You may also be eligible for special medical compensation for loss of use of a creative organ.
Click to expand...
GS,

I currently have another cystocele and I will defer surgery (no way am I willing to go through
that again). My GYN didn't write me a profile as "I had so many other profiles that will cover the restrictions".
Of course the formal board states I need to get a profile for the condition. She now wont right one because lawyers are involved. What the hell do I do now? In the meantime the Formal board has sent back my packet to get my incontinence evaluated (Already went to Urology this already happened and nothing can be done) the formal board wants a camera inserted into my bladder. I gives two damns about the incontinence. Even with the civilian specialist recommendations of a lifetime lifting restriction after repair you'd think with a current cystocele someone would write the damn profile.
 
You must log in or register to reply here.
Top